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Headaches? What do they mean?

Headaches affect many people around the world and can really affect a person’s quality of life and ability to function. Considering they are so prevalent, this series of posts will give an overview of the main types of headaches out there and what the best course of management is for each. 



Headaches are classified into two groups: primary and secondary. Primary headaches are those where the headache itself is the main problem and that is the feature that is treated. Secondary headaches are those which present as a symptom of another disease or disorder. In this case, to deal with the headache, the actual problem needs addressing. This can range from something as simple as a cold to cancer. A hangover headache or caffeine withdrawal headache would also be considered a secondary headache!





In this post, we will go briefly over the different types of primary headaches and do a separate post on each type in more detail. 



Tension Type Headache 


This is the most common type of primary headache. It is considered a ‘featureless’ headache meaning it is generally not associated with other symptoms like with migraines and cluster headaches. 


They tend to affect both sides of the head in a band-like type of pain and an intensity typically categorised as mild-moderate. There can be sensitivity around the neck muscles as well. Most Tension Type headaches can last for a few hours up to a few days. 


The cause for Tension Type Headaches is not entirely clear. It is thought that the pain receptors in the connective tissue of the head become sensitised meaning that they become more susceptible to pain. The muscles of the neck merge with the connective tissue in the head so the spreading of this sensitisation can occur to these areas as well explaining the pain felt around the neck and top of the shoulders. WHy the initial sensitisation occurs is unclear but it has been correlated with stress. 


Management for these headaches are typically relaxation, heat, stretching, massage and over the counter pain pharmaceuticals such as paracetamol and ibuprofen. 


Tension type headaches can be managed by a Physiotherapist or an Osteopath so if you struggle with these types of headaches, call in and get some help today!




Migraine Headache 


Migraines are another relatively well known type of headache that tend to have more prolific symptoms. They are considered to be a featured headache as they have a plethora of symptoms such as nausea and vomiting, sensitivity to light and sound along with the headache. The headache itself is unilateral with referral around the head and face on the one side. 


A migraine is also classified as Phasic as it has 4 phases to its process from start to finish. Each phase has a different set of symptoms and will affect each person differently. 


Treatment for Migraines is typically pharmaceutical and depending on the chronicity and intensity of the condition, preventative medication can be prescribed. There are many known triggers for migraines so being able to identify what triggers one's migraines can be incredibly valuable in preventing the escalation of an oncoming episode or being able to prevent them.


Cluster Headaches 


Cluster headaches are a rare type of headache of unknown cause. They can be terribly debilitating especially to those who have a high frequency of occurrence, 

They tend to be unilateral in presentation causing pain around the eye and temple area. They are classified as severe in pain levels and can also be described as a stabbing pain. They can last between 15 minutes to 3 hours and can occur from every other day up to 8 times a day- depending on the intensity of one's case. These headaches general recur until a period of remission is reached which can last up to a year. 


Cluster headaches are a featured headache and are associated with a variety of symptoms that tend to affect the eye:

  • Ptosis: droopy eyelid

  • Myosis: Constriction of the pupil

  • Conjunctival injection: blood shot eyes

  • Lacrimation: teary eyes

  • Rhinorrhea: runny nose and congestion in the sinuses

  • Periorbital swelling: swelling around the eye

  • Facial swelling on side 

  • Facial flushing 


It is thought that the mechanisms behind cluster headaches triggers off the autonomic nervous system which controls our glands and smooth muscle hence the additional side effects of the face in the zones of where the pain is located. 


Treatment of cluster headaches requires management from a doctor. What has been found to help reduce symptoms is inhaling 100% Oxygen when the headache is occuring. Triptan medications are also prescribed during the painful episodes (also used to treat migraines). 

A patient is often given prednisone and/or other prescribable medication when they are in remission to try prevent or delay future episodes.

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